Individual
DEJA LINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 MOUNTAIN ASH LN UNIT C, MYRTLE BEACH, SC 29579-3490
(843) 575-8768
Mailing address
109 MOUNTAIN ASH LN UNIT C, MYRTLE BEACH, SC 29579-3490
(843) 575-8768
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7994
SC
Other
Enumeration date
06/18/2022
Last updated
06/18/2022
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